HomeMy WebLinkAboutSump Pump InspectionaF PRIO~
~~ ~ City of Prior Lake
Sump Pump and I/I Reduction
Ins~ection Form
Name: ~~"/~ ~,C~,~~ ~i ~(., !~.
~!
Address: !~d ~Z ~ "~N ~ ~o
Prior Lake, MN 55-~ ~~' Phone` y~p ~~~!
Date:" 7 ~ ~g Time.J~"~-'a.m./p.m.
First In~spe~c~ ~d ~ ,~.
Own: C~-''" Rent: ~ Age of Home: ~-~ ~
Residential: ~
Non-Residential: Q ~'
A. BASEMENT es ~ No~ ~ SUMP BA5KET 1~ 2 ~ 3 ~
WATER IN BASKET ~ Yes Q~1Qq SiJMP P~ 0 Q 1 ~ 2~ ~~'~'~
WATER IN BASEMENT (flow over floor) D Yes L~~'No CISTERN Q Yes ~1Qo
(If no pump, place sticker across edge of sump cover and basement floor so any removal of cover will
break seal. Skip to Part B of this form. )
Discharge Point O Laundry tub ~ Sanitary sewer ~ Outside
at Inspection: ~ Floor drain ~ Other -"
B.
C.
D.
NOTES
Prior to Inspection:
When was system installed, or most recently modified? (Date)
and why
~ Home came with system ~ Response to inspection program ~ Other
~ Water in basement ~ Prev' system failed
ROOF LEADERSs ~No DISCHARGE: O Near C3-'Awa
Y
YARD DRAINS ~ Yes Q~'N/o ~~ WINDOW WELLS ~ Yes ~
BEAVER SYSTEM d Yes l~~iQo
PROPERTIES WITH SUMP PUMPS
When does pump run? ~ Fall ~ Summer ~ Spring
(check all that apply) How often does pump run? "
V~here does pump discharge to outside? ~ Front D Baclc-~-
O Side
SUMP PUMP SYSTEM: CZYPASS ~ FAIL You have 30 days to bring your system into complianee with current
regu[ations. When you are ready for reinspection, cal[ 6511644-1469 for an appointment.
Is there another place where clear water enters the sanitary sewer system? ~ Yes L~iQ~o
Where is this location?
This area will need to b ix so the cle r er scharges to the storm sewer system.
Inspector. Date: ' '
Resident:, Date: - - ,
Disclaimer: This vis~s~ec~ion is d~e with due diligence to find obvious clear water cross-connections
and does not imply the structure mee all City Codes.
~ Winter
White: Homeowner Yellow: City Pink: HRG